The Clinical Correlation Between PBEF And ARDS Or HPS In Children

Objective: To evaluate clinical correlation between pre-B cell colony-stimulating factor (PBEF) and acute respiratory distress syndrome (ARDS) inchildren.Method:1. The plasma and clinical data from children diagnosed withARDS in our hospital pediatric intensive care unit (PICU) and healthy childrenwere collected.2. PIM2and PRISM scores were calculated on the sampling dayitself.3. The PBEF levels of the enrolled children were measured by enzyme-linked immunosorbent ssay (ELISA).4. The statistical methods were used toanalyzed the clinical correlation between plasma PBEF levels and children withARDS.Results:1. The plasma and clinical materials of59children with ARDSand20healthy children were collected. Among59children with ARDS,46children survived and13children were non-survival.2. Non-survivors hadhigher PIM2score and PRISM score than survivors (P<0.001, P=0.044).3.Compared with healthy children, PBEF levels were markedly elevated in childhood ARDS patients [10.74ng/ml (IQR:5.84-18.81ng/ml) VS6.72ng/ml(IQR:5.18-8.73ng/ml), P=0.017]. In childhood ARDS patients, non-survivorshad higher plasma PBEF levels than survivors [21.55ng/ml (IQR:13.24-23.71ng/ml) VS8.41ng/ml (IQR:5.02-12.23ng/ml), P=0.002].4. Elevated PBEFlevels positively correlated with higher WBC (r=0.236, P=0.036) and Neu(r=0.294, P=0.009). There was no correlation between the PBEF levels and PIM2score or PRISM score (P>0.05).Conclusion: Plasma PBEF levels were significantly increased in childrenwith ARDS, and non-survivors had higher plasma PBEF levels than survivorsamong the childhood ARDS. It is indicated that PBEF is a potential biomarkerfor childhood ARDS, which may be helpful for diagnosis and prognosis ofchildhood ARDS. However there was no correlation between the PBEF levelsand PIM2score or PRISM score, indicating that the potency of prognosis ofPBEF is still remained to be further studied. Objective: To evaluate clinical correlation between pre-B cell colony-stimulating factor (PBEF) and hemophagocytic syndrome (HPS).Method:1. Serums and clinical data of the following children werecollected: pre-treatment of children with HPS, effective treatment of childrenwith HPS, death in children due to HPS, healthy children, sepsis children andnewly diagnosed children with acute lymphoblastic leukemia (ALL).2. Theabove children were divided into six groups: HPS pre-treatment group, HPSeffective treatment group, HPS death group, healthy group, sepsis group andALL group.3. Serum PBEF levels of above children were measured by ELISAassay.4. The statistical methods were used to compare the serum PBEF of eachgroup, and then analyzed the correlation between serum PBEF levels and HPS.Results:1. Serum PBEF levels of HPS pre-treatment group weresignificantly higher than healthy group [33.78ng/ml (IQR：10.28-63.40ng/ml)VS5.37ng/ml (IQR：4.84-6.38ng/ml), P=0.003].2. The serum PBEF levels ofHPS pre-treatment group were significantly higher than sepsis group (8.36ng/ml, IQR:4.00-13.01ng/ml) and ALL group (5.75ng/ml, IQR:4.71-7.34ng/ml)(P=0.01, P=0.004). There were no statistically difference among healthygroup, sepsis group and ALL group (P>0.05).3. The serum PBEF levels of HPSpre-treatment group (33.78ng/ml, IQR:10.28-63.40ng/ml) were significantly higher than HPS effective treatment group (5.87ng/ml, IQR:4.14-7.75ng/ml)(P=0.001), but were not different with HPS death group (95.24ng/ml, IQR:16.76-211.82ng/ml)(P=0.328). The serum PBEF levels of HPS effectivetreatment group did not have statistically difference with healthy group(P=0.550). The serum PBEF levels of HPS death group were significantlyhigher than HPS effective treatment group and healthy group (P=0.004,P=0.001).6. The PBEF levels were positively correlated with temperature(r=0.343, P=0.004) and SF (r=0.651, P=0.001).Conclusion:1. Compared with healthy children, children with sepsis orALL, the serum PBEF levels of children with HPS were significantly increased,suggesting that PBEF may be helpful for diagnosing and differential diagnosisin HPS.2. PBEF levels in children with HPS were markedly elevated anddeclined to normal levels after effective therapy, while the death of childrenwere not reduced to normal levels. These data may suggest that PBEF isassociated with progress of HPS and is a good prognostic indicator in HPS. Ifthe PBEF levels did not reduced during treatment in child with HPS, cliniciansshould be alert to whether the child’s condition was uncontrolled or worse.